Learn what to expect during the late stage of Alzheimer’s.

Receiving the news that an older loved one has been diagnosed with Alzheimer’s is life-altering. Thinking through the various elements and aspects associated with disease, as well as its impact, both now and in the long term, can be overwhelming. In this three-part series, we’ve explored early, middle and late stage Alzheimer’s, detailing the specific type of care recommended during each stage, what family caregivers should expect, and how At-Home Care Company, providers of home care assistance in Des Moines, Iowa and nearby areas, can help.

Caregiving in the Late Stage of Alzheimer’s

In the final stage of Alzheimer’s or dementia, which may last a number of years, needs become much more pronounced. It’s very important to ensure comfort and safety, something that becomes more difficult as the older adult loses the capability to communicate verbally. Self-care for the caregiver is also essential in this stage, as providing care is often both physically and emotionally draining.

Here’s what you may expect to encounter with late stage Alzheimer’s:

Increased Care Needs:

  • Assistance with walking (and then transferring when walking is no longer feasible)
  • Help with drinking/eating, as swallowing becomes more difficult
  • Round-the-clock assistance with personal hygiene needs
  • Monitoring for and addressing any physical health concerns

Ways to Help

Because the older adult will lose the ability to communicate how she or he is feeling and what exactly is needed, you’ll want to pay close attention to nonverbal cues. Proactive care is achievable through thoughtful planning of the senior’s day, attempting to stick as close to a routine as you can for mealtimes, using the bathroom, exercise/repositioning, etc. These guidelines can help make sure the senior gets the very best quality of life and dignity.


  • Foster as much autonomy as you can. Provided that the senior can still self-feed, allow extra time and present foods that are easier to manage, such as finger foods in small, bite-size portions.
  • Ensure your loved one is sitting upright during mealtime, and also for a period of at least 30 minutes after eating.
  • Offer plenty of liquids. The senior may have lost his/her sensation of thirst, and could forget to drink.
  • Keep an eye on the senior’s weight. Even though some amount of weight loss is to be expected with this stage, it’s important to report weight loss to the doctor when noted, for recommendations.

Using the Bathroom:

  • A bedside commode can be very helpful in this stage. Help the senior as needed for safety, but again, let him/her manage as much of the task as possible independently.
  • Reminders to utilize the toilet at frequent intervals throughout the day will help prevent an accident.
  • It’s a smart idea to keep adult diapers and extra absorbent pads on hand to use as needed, particularly overnight.
  • The older adult might not have a daily bowel movement. However, speak with the doctor if she/he appears to be constipated, and particularly if it has been a few days since the last bowel movement.

Personal Care:

  • Keeping the older adult’s skin clean and dry is extremely important to avoid sores. A daily bath/shower is not necessary, however. A bed bath can be just as effective.
  • Make sure to help your loved one change position a minimum of every two hours. If bedbound, use foam wedges or pillows to ease pressure, and learn proper turning and repositioning techniques.
  • Incorporate physical movement into every day, in accordance with the physician’s recommendations and approval. Even just bending and lifting the legs and arms will help prevent joint freezing.

You can create a soothing environment for the senior by focusing your energy on sensory stimulation, such as by:

  • Reading out loud or listening together to a favorite audio book
  • Playing or singing his/her favorite music
  • Sitting outside when weather permits
  • Smoothing scented lotion onto the skin
  • Baking a favorite treat or meal
  • Reminiscing together through photo albums
  • Bringing in a pet therapy animal for the older adult to hold or pet

Reach out to our dementia care team at At Home Care Company for additional ideas to allow for the highest quality of life for a senior in the late stage of Alzheimer’s. We are here 24/7 to help as much or as little as you’d like.

Email or call us any time at (515) 292-2650 for additional information about our trusted independent senior living in Waukee and the surrounding communities.